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NPI Code Detail

MEDICARE: DR. PHILLIP M TRUONG PHARM.D

MEDICARE: DR. PHILLIP M TRUONG PHARM.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist18073NC

General Provider Information

NPI Number : 1447583968
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILLIP M TRUONG PHARM.D
Provider Business Mailing Address
First Line : 5040 BEATTIES FORD RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-2835
Country : US
Telephone Number : 704-394-1714
Fax Number : 704-394-8743
Provider Business Practice Location Address
First Line : 5040 BEATTIES FORD RD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28216-2835
Country : US
Telephone Number : 704-394-1714
Fax Number : 704-394-8743
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2009
Last Update Date : 09/15/2009

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